S.Amdt. 2877

SA 2877. Mr. LANKFORD submitted an amendment intended to be proposed
by him to the bill H.R. 3762, to provide for reconciliation pursuant to
section 2002 of the concurrent resolution on the budget for fiscal year
2016; which was ordered to lie on the table; as follows:

At the appropriate place, insert the following:

SEC. __. HEALTH CARE COMPACT PILOT PROGRAM.

(a) Establishment.--The Secretary of Health and Human
Services (referred to in this section as the ``Secretary''),
acting through the Administrator of the Centers for Medicare
& Medicaid Services, shall establish a pilot program to
permit at least 5 States to enter into the health care
compact described in subsection (d).
(b) Eligibility.--To be eligible to participate in the
pilot program established under

[[Page S8310]]

subsection (a), a State shall certify to the Secretary,
that--
(1) the State has, in a manner consistent with that State's
constitution, joined the Health Care Compact on or before
January 1, 2017;
(2) all funds transferred to the State under subsection
(f)(5) will be expended only on health care as defined in
subsection (f)(1)(D); and
(3) the State has appointed a member to the Interstate
Advisory Health Care Commission established under subsection
(f)(6).
(c) Exclusions to Compact Consent.--Notwithstanding the
consent to the Health Care Compact granted under this
section, the powers granted to member States under paragraphs
(2), (3), and (4) of subsection (f) (the Health Care Compact)
shall not apply with regard to the agencies described in
subsection (d), and the Member State Base Funding Level and
Member State Current Year Funding Level shall not include
funds expended by such agencies.
(d) Excluded Agencies.--The agencies described in this
subsection are--
(1) the National Institutes for Health;
(2) the Centers for Disease Control and Prevention; and
(3) the Food and Drug Administration.
(e) Request for Applications and Announcement of
Determinations.--
(1) Applications.--Not later than January 1, 2017, the
Secretary shall publish a request for applications to
participate in the program established under subsection (a).
The period for accepting such applications shall close on
June 30, 2017.
(2) Determinations.--Not later than December 31, 2017, the
Secretary shall notify States submitting applications under
paragraph (1) of the determinations of the Secretary with
respect to such applications.
(f) Health Care Compact.--The health care compact described
in this subsection is as follows:
(1) Definitions.--In this subsection:
(A) Commission.--The term ``Commission'' means the
Interstate Advisory Health Care Commission established under
paragraph (6).
(B) Compact.--The term ``Compact'' means the Compact
described in this subsection that is entered into by a State
under the program established under subsection (a).
(C) Effective date.--The term ``effective date'' means the
date upon which this Compact shall become effective for
purposes of the operation of State and Federal law in a
Member State, which shall be the later of--
(i) the date upon which this Compact shall be adopted under
the laws of the Member State; or
(ii) the date upon which this Compact receives the consent
of Congress pursuant to Article I, Section 10, of the United
States Constitution, after at least two Member States adopt
this Compact.
(D) Health care.--The term ``health care'' means care,
services, supplies, or plans related to the health of an
individual and includes--
(i) preventive, diagnostic, therapeutic, rehabilitative,
maintenance, or palliative care and counseling, service,
assessment, or procedure with respect to the physical or
mental condition or functional status of an individual or
that affects the structure or function of the body;
(ii) sale or dispensing of a drug, device, equipment, or
other item in accordance with a prescription; and
(iii) an individual or group plan that provides, or pays
the cost of, care, services, or supplies related to the
health of an individual;

except any care, services, supplies, or plans provided by the
Department of Defense and Department of Veteran Affairs, or
provided to Native Americans.
(E) Member state.--The term ``member State'' means a State
that has--
(i) an application for participation in the program
established under subsection (a) approved by the Secretary;
and
(ii) adopted the Compact under the laws of that State.
(F) Member state base funding level.--The term ``member
State base funding level'' means a number equal to the total
Federal spending on health care in the member State during
Federal fiscal year 2010. On or before the effective date,
each member State shall determine the member State base
funding level for its State, and that number shall be binding
upon that member State.
(G) Member state current year funding level.--The term
``member State current year funding level'' with respect to a
member State, means the member State base funding level
multiplied by the member State current year population
adjustment factor multiplied by the current year inflation
adjustment factor for the State.
(H) Member state current year population adjustment
factor.--The term ``member State current year population
adjustment factor'' with respect to a member State, means the
average population of the member State in the current year
less the average population of the member State in Federal
fiscal year 2010, divided by the average population of the
member State in Federal fiscal year 2010, plus 1. The average
population in a member State shall be determined by the
United States Census Bureau.
(I) Current year inflation adjustment factor.--The term
``current year inflation adjustment factor'' means the total
gross domestic product deflator in the current year divided
by the total gross domestic product deflator in Federal
fiscal year 2010. The total gross domestic product deflator
shall be determined by the Bureau of Economic Analysis of the
Department of Commerce.
(2) Pledge.--The member States shall take joint and
separate action under this Compact to return the authority to
regulate health care to the member States consistent with the
goals and principles articulated in this Compact. The member
States shall improve health care policy within their
respective jurisdictions and according to the judgment and
discretion of each of the member States.
(3) Legislative power.--The legislatures of the member
States have the primary responsibility to regulate health
care in their respective States under the Compact.
(4) State control.--Each member State, within its State,
may suspend by legislation the operation of all Federal laws,
rules, regulations, and orders regarding health care that are
inconsistent with the laws and regulations adopted by the
member State pursuant to this Compact. Federal and State
laws, rules, regulations, and orders regarding health care
shall remain in effect unless a member State expressly
suspends such laws, rules, regulations and orders pursuant to
the authority provided under this Compact. For any Federal
law, rule, regulation, or order that remains in effect in a
member State under this paragraph after the effective date,
that member State shall be responsible for the associated
funding obligations in its State.
(5) Funding.--
(A) In general.--Each Federal fiscal year, each member
State shall have the right to Federal funds up to an amount
equal to its member State current year funding level for that
Federal fiscal year, provided by Congress as mandatory
spending and not subject to annual appropriation, to support
the exercise of member State authority under this Compact.
Such funding shall not be conditional on any action of or
regulation, policy, law, or rule being adopted by the member
State.
(B) Initial funding level.--By the beginning of each
Federal fiscal year, Congress shall establish an initial
member State current year funding level for each member
State, based upon reasonable estimates. The final member
State current year funding level shall be calculated, and
funding shall be reconciled by Congress based upon
information provided by each member State and audited by the
Government Accountability Office.
(6) Interstate advisory health care commission.--
(A) Establishment.--There shall be established by the
members States an Interstate Advisory Health Care Commission
to be composed of members appointed by each member State
through a process to be determined by each member State. A
member State may not appoint more than two members to the
Commission and may withdraw membership from the Commission at
any time. Each Commission member shall be entitled to one
vote. The Commission shall not act unless a majority of the
members are present, and no action shall be binding unless
approved by a majority of the Commission's total membership.
(B) Chairperson; bylaws; meetings.--The Commission shall
elect from among its membership a Chairperson. The Commission
may adopt and publish bylaws and policies that are not
inconsistent with the Compact. The Commission shall meet at
least once a year, and may meet more frequently.
(C) Studies and recommendations.--The Commission may study
issues of health care regulation that are of particular
concern to the member States. The Commission may make non-
binding recommendations to the member States. The
legislatures of the member States may consider such
recommendations in determining the appropriate health care
policies in their respective States.
(D) Information and data.--The Commission shall collect
information and data to assist the member States in their
regulation of health care, including assessing the
performance of various State health care programs and
compiling information on the prices of health care. The
Commission shall make this information and data available to
the legislatures of the member States. Notwithstanding any
other provision in the Compact, no member State shall
disclose to the Commission the individually identifiable
health information of any individual, nor shall the
Commission disclose any such health information of any
individual.
(E) Funding.--The Commission shall be funded by the member
States as agreed to by the member States. The Commission
shall have the responsibilities and duties as may be
conferred upon it by subsequent action of the respective
legislatures of the member States in accordance with the
terms of the Compact.
(F) Limitation.--The Commission shall not take any action
within a member State that contravenes any State law of that
member State.
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